8 Nursing Tips When Caring For Geriatric Patients In The ER

Geriatric nursing presents a unique set of difficulties and situations for the ER nurse. In this article, learn some tips to help you navigate these waters and how to connect with this vulnerable population. They have paved the way for us, now it is our duty to return the favor with premium nursing care. Nurses Announcements Archive Article

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8 Nursing Tips When Caring For Geriatric Patients In The ER

As ER nurses it is imperative that we recognize our geriatric patients as both a unique and vulnerable population. Yes, they are adults, but given their age, the type of care they require is different than the general adult population. Below are some tips to strengthen your relationship with this population and in turn, improve the quality of care you are able to deliver.

1. Strike up a conversation

As humans, it is pivotal for our overall health to have meaningful interactions with one another. The geriatric population, depending on their situation, could really be lacking and in great need of genuine human to human interaction. So, ensure that you take the time to strike up a conversation with them. Below is a list of some of my favorite talking points:

-How many children do you have?

-What did you used to do for work?

-What are your hobbies?

-What type of music do you like?

-You will really impress them if you then pull out your phone and play a song they love!

-How long have the two of you been married?

-What is the secret to living such a long life?

-What do you think of social media? (This is one of my favorites!)

-What do you think of these young kids these days?

2. Give them a warm blanket

Nothing is better than a warm blanket no matter what your age is. Specifically for the geriatric population, they tend to be more sensitive to the cool environment of the ER. Even if they are not asking for one, just bring it over anyways. They can always say no, and if they do, just leave it at their bedside if they later change their mind.

3. Give them some freebies

It does not have to be anything grand, but anything that is free, they will take. Anything from giving them a pair of hospital sox, a box of tissues, a glass of water or even some soup. The joy will be beaming from their faces. Can you see it now? I can!

4. Tread lightly with the Narcotics and Benzodiazepines

With the amount of the above drug classes of medications we give in the ER, it can be easy to forget how different populations might react differently. A "normal" dose to the general ER population, might be dangerous for this population. As we age, our body systems do not function in the same capacity they once used to. This can potentially cause medication accumulation, leading to medication toxicity.1

5. Don't let them convince you they can "walk just fine"

The last thing that any geriatric patient needs to do is fall. No matter where they are at the time of the fall, it is not a good situation and a poor outcome can be the result. Normally, geriatric patients in the ER are at their most acute phase of treatment. It's a new environment, new faces, they might be attached to a monitor, have an IV and maybe some new medications too. Remember that free pair of hospital sox you gave them earlier? It might be saving your behind as this moment, as you run across the department when you see your patients trying to get out of bed!

6. Be gentle with their skin

Aging skin, plus a good possibility that they are on some sort of blood thinner or aspirin, IV starts and blood draws, will lead to some serious battle wounds for the geriatric population. Try to be as gentle and cognizant of this fact as you can. Something as simple as using paper tape instead of silk tape can make a huge difference.

7. Does the 89 year old women really need that 18G IV?

Choose your IV gauge size wisely for any population, especially the geriatric population. I fully understand large-bore IVs in critical patients, but truly ask yourself if they really need that large of an IV. Their vessels are not what they used to be and their skin as mentioned above is extremely fragile. Use caution and go slow.

8. Communication is key

Talk slow, make eye contact, make sure they have their glasses on and hearing aids in. Also, be careful that they are just not nodding and agreeing with you. They can be tricky sometimes ? Keep their caregivers (if present) in the loop too.

With all of the above being said, as busy as we get in the ER, we must not forget or push aside, those who have paved the way before us.

Michael M. Heuninckx RN-BSN

Reference

1. Medscape: Medscape Access

If you like this article then you might want to check out Michael's new book for nurses...

Code Blue! Now What? Learn What To Do When Your Patients Need You The Most!

Nurse Practitioner / Author
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Jomillah

12 Posts

Specializes in Emergency Nursing.

I really enjoy the elderly that come into my ER. They are sincere, friendly, and rarely complain. I live in a large military community and always strike up conversation with the old vets about their service. I thank them and they thank me. The elderly are under rated!

Nurse Practitioner / Author

Michael M. Heuninckx

11 Articles; 43 Posts

Specializes in Emergency Department.
I really enjoy the elderly that come into my ER. They are sincere

I agree that it is refreshing to care for those who are genially sincere and grateful for the care as nurses we provide.

Michael M. Heuninckx RN-BSN

What a shockingly patronising article. Older people are not a different species. Sure they have different needs but do we really think playing them a tune they recognise on our phone or giving them something free will 'make their eyes light up'? You make them sound like toddlers. My parents are older people (geriatrics? You still use this language huh?) and they would be hugely offended by the idea that free soup is thought to cheer them up or that any professional nurse needs prompting on how to ask them about their lives.

bebbercorn

455 Posts

Specializes in Family practice, emergency.

Love working with our elderly patients. I'd add anticholinergics to your "tread carefully" section. Benadryl has induced many moments that are unforgettable for me, including making an 80 something year old woman strip bare and run free down the hall. (I hope she doesn't remember that part)

Specializes in LTC and Pediatrics.

I work LTC and I do agree with the above. You need to develop a trusting relationship with them and when in the ER, you don't have very long to do that. After having spent a couple of hours in the ER the other day (I would be considered "older" by many) there was an elderly man who presented with pretty much the same symptoms as mine. I can tell you we were treated as individuals, not exactly the same. The sign of a good nurse is one who sees them as individuals and not as an age population.

AZQuik

224 Posts

The sign of a good nurse is one who sees them as individuals and not as an age population.

Yes. This quote is not Ed or age specific. Everyone is different, and things go smoother when I remember/act like that! Great post!

BSN GCU 2014.

Sent from my iPhone using allnurses

Specializes in LTC.

I may be splitting hairs here, but I avoid asking how many children someone has as I've encountered many older folks who were unable to have children or have outlived their children. Bringing up that subject can cause undue emotional pain. At best, I'll ask who they know that lives around here and where they're from. That usually sheds some light on family ties for me to build a rapport on. Just my experience.

AcuteHD

458 Posts

What a shockingly patronising article...My parents are older people (geriatrics? You still use this language huh?)...

1) Strike up a conversation

2) Give them a warm blanket

3) Give them some freebies

4) Tread lightly with the Narcotics and Benzodiazepines

5) Don't let them convince you they can walk just fine"

6) Be gentle with their skin

7) Does the 89 year old women really need that 18G IV?

8) Communication is key

Which point is it you find so offensive??

Is geriatric a bad word now? Has anyone told AARP? Just a quick search on their website suggests they're okay with it, for example:

American Geriatrics Website - AARP